Jin Seung-Hyun, Chung Chun Kee, Kim Jeong Eun, Choi Young Doo
Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea. ; Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul, Korea.
Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea. ; Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul, Korea. ; Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea. ; Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Korea.
J Korean Neurosurg Soc. 2014 Dec;56(6):455-62. doi: 10.3340/jkns.2014.56.6.455. Epub 2014 Dec 31.
To propose a new measure for effective monitoring of intraoperative somatosensory evoked potentials (SEP) and to validate the feasibility of this measure for evoked potentials (EP) and single trials with a retrospective data analysis study.
The proposed new measure (hereafter, a slope-measure) was defined as the relative slope of the amplitude and latency at each EP peak compared to the baseline value, which is sensitive to the change in the amplitude and latency simultaneously. We used the slope-measure for EP and single trials and compared the significant change detection time with that of the conventional peak-to-peak method. When applied to single trials, each single trial signal was processed with optimal filters before using the slope-measure. In this retrospective data analysis, 7 patients who underwent cerebral aneurysm clipping surgery for unruptured aneurysm middle cerebral artery (MCA) bifurcation were included.
We found that this simple slope-measure has a detection time that is as early or earlier than that of the conventional method; furthermore, using the slope-measure in optimally filtered single trials provides warning signs earlier than that of the conventional method during MCA clipping surgery.
Our results have confirmed the feasibility of the slope-measure for intraoperative SEP monitoring. This is a novel study that provides a useful measure for either EP or single trials in intraoperative SEP monitoring.
提出一种有效监测术中体感诱发电位（SEP）的新方法，并通过回顾性数据分析研究验证该方法在诱发电位（EP）和单次试验中的可行性。
所提出的新方法（以下简称斜率测量法）定义为每个EP峰值处的幅度和潜伏期相对于基线值的相对斜率，它对幅度和潜伏期的变化同时敏感。我们将斜率测量法用于EP和单次试验，并将显著变化检测时间与传统的峰峰值方法进行比较。当应用于单次试验时，在使用斜率测量法之前，每个单次试验信号都用最佳滤波器进行处理。在这项回顾性数据分析中，纳入了7例因未破裂大脑中动脉（MCA）分叉处脑动脉瘤而接受脑动脉瘤夹闭手术的患者。
我们发现这种简单的斜率测量法的检测时间与传统方法相同或更早；此外，在MCA夹闭手术期间，在经过最佳滤波的单次试验中使用斜率测量法比传统方法更早地提供警告信号。
我们的结果证实了斜率测量法用于术中SEP监测的可行性。这是一项新颖的研究，为术中SEP监测中的EP或单次试验提供了一种有用的方法。
